Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis

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@article{fba18d414d024503a00bfca6c345d50b,
title = "Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis",
abstract = "ObjectivesThe aim of this study was to estimate the cost-effectiveness of a model OA consultation for osteoarthritis to support self-management compared with usual care. Methods An incremental cost-utility analysis using patient responses to the 3-level EQ-5D questionnaire was undertaken from a UK National Health Service perspective alongside a two-arm cluster-randomised controlled trial. Uncertainty was explored through the use of cost-effectiveness acceptability curves. Results Differences in health outcomes between the model OA consultation and usual care arms were not statistically significant. On average, visits to the orthopaedic surgeon were lower in the model OA consultation arm -0.28 (95% CI: -0.55, -0.06). The cost-utility analysis indicated that the model OA consultation was associated with a non-significant incremental cost of £-13.11 (95% CI: -81.09, 54.85) and an incremental QALY of -0.003 (95% CI: -0.03, 0.02), with a 44% chance of being cost-effective at a threshold of £20,000 per QALY gained. The percentage of participants who took time off and the associated productivity cost was lower in the model OA consultation arm.ConclusionImplementing NICE guidelines using a model OA consultation in primary care does not appear to lead to increased costs, but health outcomes remain very similar to usual care. Even though the intervention seems to reduce the demand for orthopaedic surgery, overall it is unlikely to be cost-effective. ",
keywords = "ICECAP, implementation, Primary care, cost-effectiveness, NICE osteoarthritis guidelines, EQ5D",
author = "Raymond Oppong and Sue Jowett",
year = "2018",
month = mar,
day = "14",
doi = "10.1093/rheumatology/key037",
language = "English",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis

AU - Oppong, Raymond

AU - Jowett, Sue

PY - 2018/3/14

Y1 - 2018/3/14

N2 - ObjectivesThe aim of this study was to estimate the cost-effectiveness of a model OA consultation for osteoarthritis to support self-management compared with usual care. Methods An incremental cost-utility analysis using patient responses to the 3-level EQ-5D questionnaire was undertaken from a UK National Health Service perspective alongside a two-arm cluster-randomised controlled trial. Uncertainty was explored through the use of cost-effectiveness acceptability curves. Results Differences in health outcomes between the model OA consultation and usual care arms were not statistically significant. On average, visits to the orthopaedic surgeon were lower in the model OA consultation arm -0.28 (95% CI: -0.55, -0.06). The cost-utility analysis indicated that the model OA consultation was associated with a non-significant incremental cost of £-13.11 (95% CI: -81.09, 54.85) and an incremental QALY of -0.003 (95% CI: -0.03, 0.02), with a 44% chance of being cost-effective at a threshold of £20,000 per QALY gained. The percentage of participants who took time off and the associated productivity cost was lower in the model OA consultation arm.ConclusionImplementing NICE guidelines using a model OA consultation in primary care does not appear to lead to increased costs, but health outcomes remain very similar to usual care. Even though the intervention seems to reduce the demand for orthopaedic surgery, overall it is unlikely to be cost-effective.

AB - ObjectivesThe aim of this study was to estimate the cost-effectiveness of a model OA consultation for osteoarthritis to support self-management compared with usual care. Methods An incremental cost-utility analysis using patient responses to the 3-level EQ-5D questionnaire was undertaken from a UK National Health Service perspective alongside a two-arm cluster-randomised controlled trial. Uncertainty was explored through the use of cost-effectiveness acceptability curves. Results Differences in health outcomes between the model OA consultation and usual care arms were not statistically significant. On average, visits to the orthopaedic surgeon were lower in the model OA consultation arm -0.28 (95% CI: -0.55, -0.06). The cost-utility analysis indicated that the model OA consultation was associated with a non-significant incremental cost of £-13.11 (95% CI: -81.09, 54.85) and an incremental QALY of -0.003 (95% CI: -0.03, 0.02), with a 44% chance of being cost-effective at a threshold of £20,000 per QALY gained. The percentage of participants who took time off and the associated productivity cost was lower in the model OA consultation arm.ConclusionImplementing NICE guidelines using a model OA consultation in primary care does not appear to lead to increased costs, but health outcomes remain very similar to usual care. Even though the intervention seems to reduce the demand for orthopaedic surgery, overall it is unlikely to be cost-effective.

KW - ICECAP

KW - implementation

KW - Primary care

KW - cost-effectiveness

KW - NICE osteoarthritis guidelines

KW - EQ5D

U2 - 10.1093/rheumatology/key037

DO - 10.1093/rheumatology/key037

M3 - Article

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

ER -